Three-dimensional printed bioresorbable scaffold for maxillofacial bone reconstruction: A Scoping ReviewThis scoping review aimed to provide an overview of current advancements in virtual planning and custom-made 3D-printed bioresorbable scaffolds, and to evaluate their clinical outcomes in maxillofacial reconstructive surgeries. Electronic searches of PubMed, EMBASE, Web of Science, Scopus, and Cochrane Library databases were conducted for publications up to June 2024. Included in the review were reports evaluating patients who underwent maxillofacial bone defect reconstruction using virtual planning and custom-made 3D-printed bioresorbable scaffolds. Data on postoperative complications, new bone formation, scaffold resorption, dental implant success/survival, and patient satisfaction were collected. The electronic search found 5799 results (3438 unique citations). A total of 54 studies were evaluated for full-text reading, of which 41 were excluded based on the inclusion criteria. Thirteen studies (6 case reports, 5 case series, one prospective clinical study and one randomized clinical trial) were included. These studies assessed the effectiveness of 3D-printed scaffolds in reconstructing maxillofacial defects, bone augmentation for dental implant placement, and regeneration of periosseous defects. Most of the 3D-printed scaffolds were biocompatible and did not cause local or systemic adverse events. However, some postoperative complications were reported, including graft exposure, wound dehiscence, and local infection. Overall, the 3D-printed scaffolds demonstrated favorable dimensional compatibility with deformities, provided durable support, promoted bone formation, achieved adequate bone union with host bone tissues, and supported dental implant placement without additional guided bone regeneration. In conclusion, custom-made 3D-printed bioresorbable scaffolds, guided by virtual planning, present a promising option for maxillofacial reconstruction due to their accuracy, osteoconductivity, and biocompatible properties.
Key Words:
Three-Dimensional Printing; Bone graft; Bone regeneration; Biocompatible materials
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NI: not informed; MSCs: mesenchymal stem cells; PCL: polycaprolactone; HU: hounsfield unit; (-TCP: beta tricalcium phosphate; (-TCP: alfa tricalcium phosphate; HA-PLLA: Hydroxyapatite/poly-l-lactide; DBM: Demineralized bone matrix; CGFs: concentrated growth factors; PRF: platelet-rich fibrin; ISQ: implant stability quotient; nHA: nanohydroxyapatite; HA: hydroxyapatite; TCP: tricalcium phosphate; rhPDGF-BB: recombinant human platelet-derived growth factor BB; PRP: platelet-rich plasma; rhBMP-2: recombinant human bone morphogenetic protein-2.1. Ahn G, Lee JS, Yun WS, Shim JH, Lee UL. Cleft Alveolus Reconstruction Using a Three-Dimensional Printed Bioresorbable Scaffold With Human Bone Marrow Cells. The Journal of craniofacial surgery. 2018;29(7):1880-3.2. Han HH, Shim JH, Lee H, Kim BY, Lee JS, Jung JW, et al. Reconstruction of Complex Maxillary Defects Using Patient-specific 3D-printed Biodegradable Scaffolds. Plast Reconstr Surg Glob Open. 2018;6(11):e1975.3. Jeong WS, Kim YC, Min JC, Park HJ, Lee EJ, Shim JH, Choi JW. Clinical Application of 3D-Printed Patient-Specific Polycaprolactone/Beta Tricalcium Phosphate Scaffold for Complex Zygomatico-Maxillary Defects. Polymers. 2022;14(4).4. Kanno Y, Nakatsuka T, Saijo H, Fujihara Y, Atsuhiko H, Chung UI, et al. Computed tomographic evaluation of novel custom-made artificial bones, "CT-bone", applied for maxillofacial reconstruction. Regenerative therapy. 2016;5:1-8.5. Mekcha P, Wongpairojpanich J, Thammarakcharoen F, Suwanprateeb J, Buranawat B. Customized 3D printed nanohydroxyapatite bone block grafts for implant sites: A case series. Journal of prosthodontic research. 2023;67(2):311-20.6. Mangano C, Giuliani A, De Tullio I, Raspanti M, Piattelli A, Iezzi G. Case Report: Histological and Histomorphometrical Results of a 3-D Printed Biphasic Calcium Phosphate Ceramic 7 Years After Insertion in a Human Maxillary Alveolar Ridge. Frontiers in bioengineering and biotechnology. 2021;9:614325.7. Rasperini G, Pilipchuk SP, Flanagan CL, Park CH, Pagni G, Hollister SJ, Giannobile WV. 3D-printed Bioresorbable Scaffold for Periodontal Repair. J Dent Res. 2015;94(9 Suppl):153s-7s.8. Saijo H, Igawa K, Kanno Y, Mori Y, Kondo K, Shimizu K, et al. Maxillofacial reconstruction using custom-made artificial bones fabricated by inkjet printing technology. J Artif Organs. 2009;12(3):200-5.9. Schuckert KH, Jopp S, Teoh SH. Mandibular defect reconstruction using three-dimensional polycaprolactone scaffold in combination with platelet-rich plasma and recombinant human bone morphogenetic protein-2: de novo synthesis of bone in a single case. Tissue Eng Part A. 2009;15(3):493-9.10. Schulz MC, Holtzhausen S, Nies B, Heinemann S, Muallah D, Kroschwald L, et al. Three-Dimensional Plotted Calcium Phosphate Scaffolds for Bone Defect Augmentation-A New Method for Regeneration. Journal of Personalized Medicine. 2023;13(3).
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